How to avoid mistakes when choosing a helper for a close and whether to rely on the state as to formulate requirements and to maintain a respectful relationship with the assistant – “Pravmir” recorded the stories of three nurses and asked experts to explain what is happening with the sphere of care of patients.
Photo: hospice charity Fund VERA / Facebook
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Today in Russia more than five million people in need of nursing care. It is people after stroke, with Alzheimer’s disease and multiple sclerosis, with injuries after the accident, dementia. Experts are sure that the need for nurses will increase. Fear of running into unscrupulous professionals have many strong in our country only formed the standard in their skills and abilities. However, others often do not understand that caring for sick people is a difficult and responsible, and simply do not respect nurses and their work.
For two years the family changed, ten nurses
In August 2017, Olga went to the suburbs to wish your aunt happy birthday. Her 80-year-old mother refused to go and stayed home in his apartment. That Saturday afternoon she fell, broke her hip, spent all night in one position, unable to rise from the pain and lack of strength, Olga was already in conversation with emergency workers who were called by neighbors for the screams of women.
The accident at once made always active and independent mother weak and helpless. From the hospital lying on a gurney they took her home – in addition to the femoral neck, were paraparesis, spinal compression fracture, started dementia.
Olga may be cared for by the mother herself, if not for the arthritis and the 3rd group of disability. Decided to hire a round the clock nurse. Wishes was the usual – to maintain hygiene, prepare meals, give medication and communicate.
For two years, Olga was replaced by ten nurses.
The first advised the nurse from the hospital. It was a woman from Moldova, she has lived in Moscow son. And she very much stole my mom’s shoes, blouses. Mom was turned to face the window and didn’t see what happened in the room, although the nurse was very fond of. And she really did everything very well, was very pious, in the output time off to the temple. And all the time said, “You already forgive me.” I could not understand what was the matter, and when she left, then saw all this… Maybe the poverty so… basically in caregivers are those who can’t find another job.
The following aides for my mother Olga tried to search both through the Agency and of private ads. Nurses were followed from “was seen by the mother that she is happy” to “her mother immediately took a dislike to”. The longest period of residence assistant in the family was five months.
– The Agency sent us a young woman from Ukraine. Everything sparkled, she was well prepared. And her mother is very fond of. And then ended her stay in Russia and she advised his friend. It was also a very intelligent woman, she tried to get the mother, gave a concert. With a broad Outlook and kind heart, never a nurse was not working, but she found in herself the desire and energy to communicate with the sick person, not to sit on the Internet until the next feeding.
One day during the may holidays Olga are unable to reach a new nurse – mobile and home phones were silent, it became obvious that the day nurse walked in, forgetting about the pupils.
About the fate of the nurses, Olga said, “Well, they left, and I stayed with her. I didn’t want to bother with them and deal with it.” Although other nurses still call her, ask how’s your mom, happy holidays.
– Of course, we need ethical rules that report for work. But to achieve something perfect is impossible, I guess. We have a sick person, me with my financial preference and a nurse with her level of literacy. But working with people is very hard work.
The need for nurses will increase
The need for specialists to care, apparently, will be increasing along with life expectancy. According to the UN, the proportion of people over 60 years old in 2000, Russia was 18.5% and in 2050 will be twice above. More than five million people in need of nursing care – 1.5 million people who have had a stroke, 3 million people with Alzheimer’s, 3 million patients with cancer, 200 thousand people with multiple sclerosis, 500 thousand people who suffer severe injury.
To search for the specialist or a nurse, many prefer using personal contacts. “Let there be man without the necessary knowledge to care, but tested” – the most common argument for fear of being unfair to a specialist. And this fear can be understood.
Market professionals to care – this area is still not very systematic, where only formed the standard for staff development. Basically, there are two players, a non – profit, charitable organizations that provide assistance, and commercial Agency.
If you search for the assistant for themselves and to go to the relevant site to find professionals, it is possible to conclude that the work of the nurse often looking for women from 40 years citizenship of Russia and CIS countries, most combine the work of nurses and maids. Many nannies, cleaning companies and social centres, some attached to the diplomas of medical colleges and pedagogical universities.
Common history – nursing services offers former nurse, long time working in families. There are also people with economic, accounting, agronomic education, gardeners and cooks who took care of his grandmother. Their fees are usually slightly lower than the agencies, but the responsibilities are often higher, for example, cleaning and cooking, which is not always present in the package of services of the Agency.
Now among nurses, graduates of medical schools and colleges is not very prestigious to devote his life to care. In addition, few of our citizens choose for themselves a profession. But when someone is faced with illness of a loved one, he understands that a lot depends on the professional and human qualities of a specialist, says the head of the nursing service “Mercy” Alena Davydova.
The nurse does not sit
Before you look for a specialist, you need to understand most importantly why do you need a sitter, because its running time depends on the condition of the person needing help, and the wishes of the family. Today in Russia there is no training program that could prepare professionals to care so a nurse can work any. And the question about her skills for many employers does not arise.
– In Russia, in nurses take those who have a strong back and good heart. If a woman has 10 years of experience in patient care and she tore open the back, so she’s strong. If doing the job so far – so good, – says the expert care Fund “an old Age in pleasure” Lena Andrew. But if it turns out that the man had worked as a loader, and now I am sure that maybe your mother transplanted from the bed to the chair, he is unlikely to fit.
But one good heart is not enough. Assistant needs to understand why it works, what is the purpose. But to achieve it, we need knowledge – sure head of home care Fund “an old Age in pleasure” Kira Belelyubsky. – When you say: “I hired my dad, the nurse. She’s very experienced”, I would advise to ask, but what’s her experience, where she is knowledge received? Because experience is no substitute for knowledge. The nursing assistants need to know very much. “Nurse” is not sitting, this man works all the time.
To the question of medical education experts are debating – it all depends on the severity of the patient. But important another – and how close your well.
– Pay attention to how the nurse in this case communicates with the patient. If the nurse is not sociable, does not feel compassion for the patient, most likely, it is not suitable for this work, claims clinical coach Senior Group Igor Poluboyartsev. – Change the diaper – it’s not nuclear physics, it is possible to train quickly. But if the person is not ready to communicate, most likely, he will have no contact with you or with your mentee.
“Without a nurse, I’m a nobody”
Lydia Ivanovna, 79 years old, and she lives with a nurse. In November 2016, the son of Lidia Ivanovna with his wife and child got in an accident – the driver of the truck fell asleep and flew into the oncoming lane. Son’s wife died on the spot, the son with serious injuries from that day is on the rehabilitation, and the grandson of Makar, after four months in the hospital, remained in the hands of the grandmother, he does not hear, not see, though and leads eyes, feel the touch, but doesn’t know anyone. Makar fed through a tube, he breathes through a tracheostomy.
Then Lidia Ivanovna had to find a helpmate. Lyudmila 45 years, a few years ago she arrived in Russia and all this time works in the service Department. To the Makar caring for critically ill man.
One room to your left Lidia Ivanovna gave Lyudmila, there is a Makar, as it requires care both day and night. Duties are divided so: Ludmila takes care of Makar, feeding him, doing gymnastics and changing body position to avoid bedsores, Lidia she shops, cooks for two, washes and cleans the apartment.
– Lyudmila includes Makar tablet audio, cartoons, songs, talking to him always: “the Weather is good, the sun is shining”, “Now I will feed you, come on over lay” – says Lidia.
Once a week, Lyudmila output, but 19 Lidia asks her to come: “Then I’m afraid there is a tube here.” “But if in the week to come Lyudmila girlfriend – says Lidia Ivanovna, – let her go for an hour. But on the phone she is always talking with family and friends. Makar can’t hear, my poor boy.”
– We each other respect. Some debate there.
It’s helping my beloved grandson, and I can’t… to be offended by something.
Put up with some things, if not put back in, saying, “People, if you do so, it will be better.” And for food Lyudmila always thanks, and I’m very grateful. Bedsores no, it’s, how well-groomed boy.
On the day of the birth of Lyudmila Lidia Ivanovna gave her a bouquet of flowers, box of chocolates and a thousand rubles. A week later, with Olivier and fish gelatine they celebrated the birthday of Lidia Ivanovna.
I’m Ludmila no one at all, though, and worked 38 years as a teacher in a kindergarten. My boy of two years does not come into creation. Ask God: “Give, God, health, because if something happens, Makar in a nursing home, and there he will perish…”
Clearly, care is not enough
Can relatives of the sick person to rely on assistance from the state? To get free the help of social worker at home, need to get into grace, certain legislation category. The social worker will come to your mentee at least twice a week and do mainly household chores – buying groceries, paying for housing and utilities to medicines and to bring the press. Often additional services, for example, to cook and to feed, help bathe, clean, are paid separately.
– It is clear that care is not enough. Progressively, man ceases to go out, then it harder to cook, then wash, to move around the apartment. And public service can’t close all these issues, though, can be and would like. And each region solves this problem in own way, – says Kira Belelyubsky. – What could the government do? It could train social workers and to begin to provide those services that really need to social services as long as possible to care for people at home.
There is hope for the professional standard “Assistant (babysitter)”, which entered into force in October 2018. He secured previously developed profoundest functions and skills of nurses. Now all market participants have a pattern that we can rely on.
It seems that the dream of professional associations to do the work of nurses in this profession today as ever closer criteria and the rules of care developed, there are responses of the government in the form of profstandart.
Inhibits banal “disrespect for the labor nurses”. And this is the main pain experts, which is not to eliminate instantly.
– It’s a job and a profession like any other. I think the problem here is that the client does not understand what this specialist. And the nurse is a specialist who has their own work schedule, knowledge, – says Alexander Korovin, founder of the service for the care of elderly people at home “Friends.ru”. Two years ago, he was on the client side – looking for a caregiver for my grandmother with dementia. – All potential employees, we run it through our training center and some people do not pass, believing that nothing should be done. And this is a difficult profession – physically and psychologically. Sometimes people die at the hands of caregivers. And it should be clearly understood that should do a specialist and that he should not.
“You work with family, and need to build relationships”
Nina Fosdick 60 years, five of them, she works as a nurse in the nursing service of assistance “Mercy”. Among those for whom she cared for patients with Alzheimer’s disease and multiple sclerosis. Year she nursed a former English teacher with Parkinson’s disease and a hip fracture and another year for 94-year-old biology Professor with multiple sclerosis. Almost all her patients are gone, the disease progressed in her eyes.
Care for bedridden patients is that you work with its surroundings, with family. And you need to build relationships. I think it is important not to get involved, not to show himself, to try to adapt. They too hard, usual life is turned upside down.
Change Nina Grigorievna lasts from six to 10 hours a day. According to her, the main thing – to comply with the work plan and responsibilities are: to follow the daily routine, to feed, to wash and to change clothes, wet cleaning of the room.
– If you feel unwell we will call the doctor. If necessary, we can prepare food for the ward, cleaning the bathroom, because I use it. Native my players never had to do anything beyond my duties. And they see the results of their labor – their own person well-groomed, fed, clean.
Nina admits that she wants to give people warm. According to her, to do professional care will be the only ones “who feel the need to make someone good, otherwise nothing happens.”
“Not men’s work? And try a man after a stroke to move”
In childhood Yuri wanted to be a cartoonist, but after school services and worked as a storekeeper-inspector at the plant “Moskvich”. And then decided to study as a paramedic in a medical school. Today Yuri a little more than 50, he works as a nurse in the service for the care of elderly people at home “Friends.ru”, the common experience of almost 30 years.
– Do you think that the nurse – not a man’s job? And try 80-kg man after a stroke to move? Imagine a non-Smoking non-drinking athletic person, pounds of the weight could lift 20 or 30 times, and here he is… the man is not that he doesn’t want to help. He just generally believes in nothing. The doctors told him that now would just be a lie. And you believe in him and try to dissuade him.
His first patient, in practice, the school became a soldier”Afghan” with an amputated leg and arm, “soldier”, as he calls it Yuri.
Boy, strong, handsome, but it happened… and he thinks it all over.
He wanted to jump… I took it off, grabbed like a child. He me as he could, beaten, bitten. I reassured him, saying that everything is ahead and everything will be fine. There is not a pill, and human communication.
These lads, crippled by the war and do not believe in the life, Yuri was 15-20 in parallel. So he began working as a rehabilitation specialist immobile and limited mobility patients in different medical and sports complexes.
Yuri admits that the work feels like a strict teacher. Now for the fourth week it eight hours a day working with a man after a stroke. Says the patient is still only trusts his wife. Hear from her: “Yuri is holding you back” and away they go.
While walking to the Park, most of which with the patient and his wife just moved across the street, Yuri saw that ward made a wry mouth, and the wife said – he was smiling. “This is my little victory,” he explains modestly.
– You know, the substitution ducks, changing diapers isn’t everything. I always ask my patients: “let me lift you up”, “let me do the massage.” Recall the phrase from the “twist of fate” – “our mistakes will be costly”.
Yuri is convinced that the profession of a nurse, unfortunately, will be massive, as large city – is a city of lonely people. Children can’t sit with sick parents, or they do not have anything yourself, and to serve them. The choice of the patient whether nurse or other employee, however, must be strictly select people.
What are nurse – expert advice of the project “Workshop of caring” Fund “Vera” Elena Kuznetsova
A companion is needed during the absence of relatives. The objectives of the companion may be:
- Help when feeding.
- Apartment cleaning, Laundry and Ironing.
- Change of bed and assistance in changing undergarments.
- The gap of communication.
- Sale of drugs products.
- Support on the walk.
The nurse professionally caring for a sick relative at home or in hospital. The tasks of nurses include:
- Conduct hygiene, skin care and oral cavity; it is necessary to have the skills of safe movement of the patient, and special techniques for care.
- The doctor may carry out a light massage, LFK.
- Conducts regular activation, prophylaxis of pneumonia, prophylaxis of bedsores.
- Control of food, water balance.
- Dynamic monitoring of the General condition of the patient, the emergence or intensification of symptoms: shortness of breath, swelling, change of chair.
- Measurement of vital indicators such as blood pressure, breathing rate, saturation (% of oxygen).
- Measurement of blood sugar levels and chat with your doctor for further advice on care.
10 tips to help you choose a nurse, according to the portal “About Palliative”
– Determine why you need a nurse.
– Prepare your loved one and a caregiver to meet each other.
– Meet personally.
– Ask about education and experience.
– Ask to see the documents.
– Offer to perform one of the manipulations.
– Discuss all the necessary tasks.
– Tell the nurse biography close.
– Rate the response close if possible.
– Make a nurse a contract.